POS0501 INVESTIGATING THE PREDICTORS OF ONE VERSUS MANY FRACTURES IN MALES REFERRED FOR BMD ASSESSMENT: AN OBSERVATIONAL COHORT STUDY
Authors: A. Khan, H. Amin, N. Rossi, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Currently there exists limited data around predictors of osteoporosis as well as fragility fractures in men.<sup>[1]</sup> It is therefore important to understand the determinants of poor bone health in males and thus predicators of fractures to help deliver optimal care. Males referred for Bone Mineral Density (BMD) estimation are a good source of exploring such predictors of fractures. We sought to investigate the determinants of one versus many fractures in a population of males routinely referred for BMD estimation using Dual X-Ray Absorptiometry (DEXA) scans. <h3>Objectives</h3> The aim of this study is to assess the predictors of one vs multiple fractures in males routinely referred for DEXA scans, in an observational cohort. <h3>Methods</h3> Data was obtained from patients referred to secondary care in the northwest of England who subsequently were assessed for low BMD via DEXA. Males referred between 2004 and 2019 were selected and data collected at attendance included patients' full medical history and body habitus. Logistic models reporting odds ratio were used to examine the predictive factors for one versus multiple fractures in the cohort. <h3>Results</h3> A total of 5390 male patients were included in this analysis, the median age at scan was 66 years and the mean age was 76.6 +/- 13.7 (SD). A total of 1853 fractures occurred in our population of males. Varying modifiable and non-modifiable factors were identified as predictors of fractures. Modifiable factors included those who drank excess alcohol. Patients who had a history of excess alcohol consumption were more likely to have multiple fractures OR: 1.260 (CI: 1.02-1.26) (p= 0.030). Furthermore, BMD at the left neck of femur was protective for multiple fractures OR: 0.938 (CI: 0.89-0.99) (p= 0.018). Interestingly the BMD at the right neck of femur was not predictive of multiple fractures. In terms of non-modifiable risk factors, height was statistically significant in being protective against fractures in this cohort OR: 0.991 (CI: 0.98-0.99) (p= 0.016). Rheumatoid arthritis, steroid use, family history and coeliac disease all produced insignificant results when predicting one versus many fractures in this male cohort. A summary of the results can be seen in Table 1. <h3>Conclusion</h3> This study identifies factors predictive of multiple fractures among males referred for BMD assessment. Our analysis shows that a history of excess alcohol consumption, altered BMD results at the left neck of femur, and height were statistically significant in the prediction of multiple fractures. Our previous study also found a relationship between excess alcohol consumption and patterns of fractures in males. Further research is required to better understand both this link and alcohol's importance in the pathophysiology of osteoporosis in men. Such research is also imperative in hypothesising specific factors relating to fractures adjusted and unadjusted for age. <h3>Reference</h3> [1]Willson T, Nelson SD, Newbold J, Nelson RE, LaFleur J. The clinical epidemiology of male osteoporosis: a review of the recent literature. Clin Epidemiol. 2015 Jan 9;7:65-76. doi: 10.2147/CLEP.S40966. PMID: 25657593; PMCID: PMC4295898. <b>Characters from table content including title and footnotes:</b> 225 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.